Question 1

Is a mild concentric LVH and Grade I diastolic dysfunction something serious for a 68-year-old woman who's had a high sugar level of 250 and has been taking medication for diabetes for 6 years and heart issues for 4 years? What steps should we be taking? Is there a concern about ischemic heart disease with these symptoms, especially given the normal echo report?

Accepted Answer

Neck Pain and Burping Symptoms

_Possible Causes_

1. _Gastroesophageal reflux disease (GERD)_: Burping and neck discomfort may be related to GERD, where stomach acid flows back into the esophagus.
2. _Dysphagia_: Difficulty swallowing or a sensation of blockage in the neck could be causing your symptoms.
3. _Musculoskeletal issues_: Neck pain might be related to muscle strain or poor posture.

_Recommendations_

1. _Antacids or acid reducers_: Over-the-counter medications like antacids (Tums, Rolaids) or acid reducers (Zantac, Pepcid) may help alleviate GERD symptoms.
2. _Dietary changes_: Avoid trigger foods (spicy, fatty, or acidic), eat smaller meals, and avoid lying down after eating.
3. _Physical therapy_: Gentle neck stretches and exercises may help relieve musculoskeletal tension.
4. _Consult a doctor_: Schedule an appointment with your primary care physician or a gastroenterologist to rule out underlying conditions.

_When to Seek Immediate Attention_

1. _Severe symptoms_: If you experience severe neck pain, difficulty swallowing, or vomiting blood, seek immediate medical attention.

Question 2

I'm really concerned about my dad's blood pressure. He's been dealing with high BP for a while, but it was stable and normal the past few days. Today it shot up to 153110 and he took his usual Tazlock 20, which has Telmisartan IP in it. Is this something we should be really worried about and what steps should we take from here?

Accepted Answer

yes you can use

Question 3

I'm a bit concerned about the price of my uncle's medication. He's been using Stamlo T to control his BP, but it costs INR 100 per strip, which seems quite steep. I found another medicine, OZOTELAM, that reportedly has the same composition and only costs INR 20 per strip. Why is there such a big price difference between these meds if they have the same ingredients? Also, would it be safe for my uncle to switch to OZOTELAM since it's more affordable, and is the composition truly identical, or am I missing something? Looking forward to your advice.

Accepted Answer

Symptoms and Possible Causes*

1. *Heaviness in the right cheek*: Possible causes include:
    1. Dental issues (e.g., toothache, abscess)
    2. Sinus pressure or infection
    3. Facial nerve issues (e.g., trigeminal neuralgia)
    4. Temporomandibular joint (TMJ) disorders
2. *Neck pain*: Possible causes include:
    1. Muscle strain or tension
    2. Poor posture
    3. Herniated disk or spinal issues
    4. Stress or anxiety
3. *Headaches*: Possible causes include:
    1. Tension headaches
    2. Migraines
    3. Sinus headaches
    4. Cervicogenic headaches (related to neck issues)
4. *Palpitations on the lips*: Possible causes include:
    1. Anxiety or stress
    2. Nerve issues (e.g., trigeminal neuralgia)
    3. Vasovagal syncope (a condition that affects blood flow)

*Recommendations*

1. *Consult a primary care physician*: Start by consulting your primary care physician to discuss your symptoms and determine the best course of action.
2. *Specialist referral*: Based on your symptoms, your primary care physician may refer you to a specialist, such as:
    1. Dentist or oral surgeon (for dental issues)
    2. ENT specialist (for sinus or ear issues)
    3. Neurologist (for nerve-related issues)
    4. Orthopedic specialist or physical therapist (for neck or spinal issues)
3. *Diagnostic tests*: Your healthcare provider may order diagnostic tests, such as:
    1. Imaging studies (e.g., X-rays, CT scans, MRI)
    2. Blood tests
    3. Nerve conduction studies
4. *Lifestyle modifications*: In the meantime, consider:
    1. Practicing stress-reducing techniques (e.g., meditation, deep breathing)
    2. Maintaining good posture
    3. Engaging in regular exercise
    4. Avoiding triggers that exacerbate your symptoms

I've been having chest pains and I got a CT angio which showed myocardial bridging of my proximal LAD at 1.8 cm. My cardiologist said everythings fine and not to worry, but I still get regular chest pains, especially when walking or climbing stairs. What do you think I should do about this?

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